Overview of Postpartum Depression

Having a baby is an exciting time in a woman’s life. It is a time of growth and change that involves constant changes in a woman’s body – which impact her physically, emotionally, and mentally. While having a baby is typically a time when parents are excited and filled with joy, it can also be a time when postpartum depression follows childbirth. This psychiatric condition disrupts what should be a joyous occasion, filling it with negative emotions and other unexpected complications.

What is Postpartum Depression?

Postpartum depression is a psychiatric disorder that affects a small percentage of women. It can strike anyone; it isn’t something that happens only to a "bad" mother who gives birth. This condition develops when, following birth, there are major drops in the woman’s estrogen and progesterone levels – the two primary female sex hormones. Hormones produced by the thyroid may also drop. All of these hormonal shifts result in troubling symptoms. Women with postpartum depression usually experience a profound sense of sadness as well as feeling like they have little or no energy.

Situational and emotional factors can also play a major role in the degree of the woman’s symptoms. Having a newborn in the home can turn a new mother’s world upside down. The demands are intense – even for a woman with no postpartum symptoms. Caring for an infant can be both stressful and exhausting. First time moms often worry if they are doing things right; fears of inadvertently harming their precious newborn in some way only add to the stress.

Many women struggle to "keep it together" as they try to juggle everything. This adds even more stress, especially if they are particularly hard on themselves by expecting that they should be a perfect mother. Additional stressors that may follow childbirth include financial struggles – the costs of formula, diapers, baby food, clothing, and postnatal care can add up very quickly; childcare – especially for women who are doing it alone or have a very limited support system; caring for older children in the home in addition to the newborn; and managing day to day tasks like cooking, cleaning, taking care of errands, and basic self-care.

Considering the incredible demands and changes that accompany the birth of a child, it’s actually amazing that more women don’t suffer from postpartum depression. For those who do, every aspect of their life can feel completely overwhelming. Even the smallest task can feel as if it is more than they can handle at times.

What are the Symptoms?

A sad, depressed mood is one of the hallmark symptoms of postpartum depression. Some mild feelings of depression are not uncommon following childbirth in most women. In fact, they’ve been nicknamed the "Baby Blues". However, the term "baby blues" is far too euphemistic to adequately describe the more serious symptoms that women with postpartum depression typically experience.

The duration of symptoms can vary significantly from one woman to the next in cases of postpartum depression. The intensity of symptoms also tends to vary widely. However, most women with postpartum depression will experience at least several of the following symptoms:

Sadness

Tearfulness

Difficulties concentrating

Erratic and severe fluctuations in mood

Anxiety or nervousness

Insomnia

Lack of appetite

Bouts of anger and irritability

Loss of pleasure from activities previously enjoyed

Excessive guilt

Low self-esteem

Difficulties bonding with their baby

Thoughts of harming the baby or self, which may include suicide or killing the newborn

Obviously, the last symptom listed is the one that causes the greatest concern – for good reason. Death or injury to an infant or its mother due to untreated postpartum depression is a tragedy. This is why it is imperative that, when violent thoughts occur, a physician is seen immediately. Even if no other symptoms of postpartum depression are present, any thoughts of self-harm or harm to the infant require immediate attention. If these thoughts are ignored and help is not sought right away, they may become more intense and more difficult to resist. A simple case of the "baby blues" doesn’t include these serious symptoms, but they are often a part of full-blown postpartum depression.

Who’s at Risk?

Although any woman has the potential to develop postpartum depression following childbirth, some are at a higher risk than others. Woman who are most at risk often have at least one or more of the following:

A history of postpartum depression

A history of any other type of depression

A family history of depression

An unstable or insecure relationship with the infant’s other parent

A high degree of stress in other areas of life

A pregnancy that was unplanned or unwanted

Financial problems

An inadequate support network

Why it’s Important to Seek Treatment

In far too many instances, women who have symptoms of postpartum depression ignore them or shrug them off. This often happens because of ignorance, embarrassment, or fear of having the disorder. It’s easy to feel inadequate as the mother of a newborn. Women with postpartum depression are especially prone to feeling incompetent and ashamed that they aren’t able to cope with the demands of motherhood – which is considered such a normal part of a woman’s life.

If you are experiencing symptoms of this condition for the first time, you can rest assured that your doctor will understand and not judge you. But your doctor can’t help you unless you tell him or her about the symptoms that you’re experiencing.

As a mother, it’s easy to neglect your own self-care. However, taking good care of yourself is just as important as caring for your newborn. The better you feel, the easier it will be to give your baby the care it needs. Part of your own self-care includes seeking treatment for your symptoms of depression. It’s truly one of the most important things you can do for yourself and for your baby. Since postpartum depression can prevent you from bonding with your newborn and providing the basic care he or she needs, failing to seek treatment can have a lasting impact on the relationship you have with your child.

Make an appointment with your gynecologist if you’re experiencing any troubling symptoms – whether they are physical or emotional. If you don’t want to go alone, ask a close friend or family member to accompany you. That additional support can help you feel more comfortable and relaxed, as well as less alone during a difficult time. Having someone else present during the appointment is also beneficial because depression can make it difficult to concentrate. You may have a hard time processing and remembering the information your doctor give you. Write down any questions you have and bring them to the appointment, or talk about them beforehand to the person who’ll be going with you. That way you’ll be sure to get all of them answered while you’re talking to your doctor.

How is Postpartum Depression Diagnosed?

Usually, your doctor will talk to you about the symptoms you are experiencing. This includes how long you’ve had them, how frequently they occur, and how intense they are. Your doctor may also want to do a physical exam and run some tests to rule out other possible causes of your symptoms.

Treatment for Postpartum Depression

A simple case of the baby blues will usually subside on its own in a short period of time without treatment. However, even if you just have mild symptoms you’ll benefit from getting extra rest, keeping your stress at a minimum – as much as possible, and taking good care of yourself in any way you can. Seek help and support for yourself and caring for your newborn to help you through this challenging period. The sooner you feel better, the sooner you can fully enjoy your precious new baby.

If you have more serious symptoms, the most effective treatment will include a combination of psychotherapy and medication. Hormone therapy may also be necessary to help bring your hormone levels back into balance.

Medication can be very helpful in reducing depressive symptoms. However, they must be taken with caution, especially if you are breastfeeding. Your doctor can advise you regarding which medications are the safest. Medication alone is usually not the best treatment for any type of depression, including postpartum depression.

Psychotherapy is an important part of treatment because it will help address the underlying issues, which includes both emotional and situational factors that may be contributing to your depression. A skilled therapist can also help you learn effective coping skills, address your parenting concerns, and teach you relaxation techniques to help with stress.

It’s often tempting to want to discontinue treatment prematurely, especially if you have financial or time constraints. However, it’s crucial that you continue with your treatment until your therapist or doctor feels you no longer need it. For some women, treatment may be necessary for just a few months. However, with postpartum depression, symptoms can last for up to a year. If you stop treatment too soon, your symptoms may reappear or get worse.

Postpartum depression is never a welcome part of your post-childbirth experience. However, it is a condition that can be treated effectively. Self-awareness and knowledge will help you quickly recognize the symptoms should they occur. If they do, get help right away so you can be the best possible mom to your new baby.

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